When to perform urodynamics before mid-urethral sling surgery for female stress urinary incontinence?

Int Urogynecol J. 2010 Mar;21(3):303-9. doi: 10.1007/s00192-009-1035-2.

Abstract

Introduction and hypothesis: Development of a model that can predict in which group of women pre-operative urodynamics can be safely omitted.

Methods: Three hundred and eighty-one uncomplicated women who underwent pre-operative urodynamics were evaluated. A multivariate logistic regression model was developed based on medical history and physical examination predicting a high probability group of women with detrusor overactivity or a low (<20 cm H2O) mean urethral closure pressure and, therefore, are likely to benefit from urodynamics.

Results: Women are likely to benefit from pre-operative urodynamics if they (1) are 53 years of age or older or (2) have a history of prior incontinence surgery and are at least 29 years of age or (3) have nocturia complaints and are at least 36 years of age.

Conclusion: If urogynaecologists omitted pre-operative urodynamics in women in the low probability group, in our population, pre-operative urodynamics would be reduced by 29%.

MeSH terms

  • Adult
  • Aged
  • Contraindications
  • Decision Support Techniques
  • Diagnostic Techniques, Urological / statistics & numerical data*
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • Preoperative Care
  • Suburethral Slings
  • Urinary Incontinence, Stress / diagnosis*
  • Urinary Incontinence, Stress / surgery
  • Urodynamics